7/29/2019 TEDx Youth@Hollywood Flyer and Permission Slip

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youTHink6505 Wilshire Boulevard, Suite 100

LA, CA 90048

Phone: 323.761.8311

Please join us for TEDxYouth@Hollywood, a free, day-long conference for youth ages 14-19. The

event will feature presentaons and performances by youth and adults with mind, heart and spirit

-expanding stories and ideas to share. The theme of this years conference is JUMPING, as in

jumping into something new, excing, scary or inspiraonal. And jumping just for the fun of

jumping!

Who: Youth (14-19 years old, free); 20-21 year olds and teachers ($20)

When: February 10, 2013, 9 AM-4PM

Where: Hollywood High School, 1521 North Highland Avenue (at Sunset), Los Angeles 90028How: Hollywood HS is accessible by public transportaon: Hollywood/Highland Staon-

Metro Red 802; Metro Local (156, 210, 212, 217, 222, 312, 656), Metro Rapid (780);

TEDxYouth is providing buses for youth at select locaons. A healthy lunch will be

provided.

Experience:

Youth and adult speakers talking about overcoming obstacles, taking risks, being a paralympian,

taking acon for social change, being undocumented, forgiveness, the power of art and more!

Performers: Breakdancing, popping, locking, and krumping performances from League of

Extraordinary Dancers (LXD), Bronkar, the worlds only rhythmic juggling beatboxer, and more!

Dynamic and fun acvies to inspire you to be creave, move you, and make you want to JUMP

and mingle!

Sunday, February 10, 9 AM-4 PM

youTHink is a program of

Register by Tuesday, February 5 at www.TEDxYouthAtHollywood.eventbrite.com

Visit: www.TEDxYouthAtHollywood.comfor updates and more info on

speakers and performers.

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Note: Students must present this permission slip to attend TEDx Youth@Hollywood and to ride transportation

provided by TEDx Youth@Hollywood/youTHink. These signed forms are due on 2/5/13 via fax at 323-761-8311 orvia email to Carla@youthink.org.

I hereby grant permission for my child to participate in the following activity:

1521 North Highland AvenueLos Angeles, CA 90028

Date:

If my child signs up for transportation at one of the designated locations, I understand that transportationwill be by: .

Departure Time: Return Time:

I understand that adequate and appropriate supervision will be provided. I recognize, however, that unanticipatedsituations and problems can arise on any trip, which situations or problems are not reasonably within the control ofthe supervising youTHink/ Zimmer Childrens Museum staffand/or the TEDx Youth@Hollywood staff (includingvolunteers). In such instances, I agree that youTHink/ Zimmer Childrens Museum staffand/or TEDxYouth@Hollywood staff (including volunteers) are not to be held legally responsible in the event of accident orinjury and I will hold youTHink/Zimmer Childrens Museum and/or the TEDx Youth@Hollywood and their staff andvolunteers harmless from any costs, liability, or related expenses.

I give permission for emergency medical attention to be administered should that be necessary during the event. Ialso give my permission for photos or video of my child taken while participating at TEDxYouth@Hollywood to beused in promotional materials for TEDx, TEDxYouth@Hollywood, youTHink and the Zimmer Childrens Museum.

Emergency Contact Information: During the event, I can be reached at:If unable to contact parent/ guardian, in case of emergency, please call: (name, relationship and phonenumber)

Please note: Submitting a permission slip does NOTguarantee your childs participation at the event.

Students must also register for the conference at:www.tedxyouthathollywood.eventbrite.com

Participation will be confirmed upon receipt ofregistration and trip slip.

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Nota: Los estudiantes deben presentar este formulario de permiso para asistir a TEDx Youth @ Hollywood y utilizarel transporte proporcionado por TEDx Youth@Hollywood/youTHink. El formulario de permiso tiene que ser

entregada para el 02/05/13 por fax al 323-761-8311 o por correo electrnico a Carla@youthink.org.

Yo/Nosotros otorgamos permiso para que mi hija/hijo participe en la siguiente actividad:

1521 North Highland AvenueLos Angeles, CA 90028

Entendemos que se proporcionar supervisin adecuada y apropiada. Reconocemos sin embargo, quepueden surgir situaciones y problemas imprevistos en cualquier viaje, problemas que no estn bajo elcontrol del personal supervisor de youTHink/Museo Infantil Zimmer y/o del personal de TEDxYouth@Hollywood (incluyendo sus voluntarios). En tales casos, nosotros convenimos en que ni el MuseoInfantil Zimmer/ youTHink y/o TEDx Youth@Hollywood y sus voluntarios podrn ser hechos legalmenteresponsables. En caso de accidente o herida, mantendremos a todo el personal de youTHink/MuseoInfantil Zimmer y/o el personal de TEDx Youth2Hollywood (incluyendo a los voluntarios) libre decualquier costo, obligacin, o gastos relacionados a este.

Yo/Nosotros otorgamos permiso para que se administre cualquier atencin mdica en caso de unaemergencia durante este paseo. Yo/Nosotros tambin otorgamos permiso de utilizar fotografas tomadasdurante este paseo para publicaciones y materiales promocinales de youTHink, Museo Infantil Zimmer,TEDx, TEDxYouth@Hollywood al igual que videos institucionales, pgina de Internet, folletos yocasionalmente peridicos.

Durante el paseo, podr ser contactada/o al: En un caso de emergencia enel que no sea posible contactar a padres/guardianes, favor de llamar a al nmero

(como esta relacionada esta persona? To? Abuela? Etc.)

____________

__ ________

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Tenga en cuenta: El envo de un formulario depermiso garantiza la participacin de su hijo/a

en el evento. Los estudiantes tambin debenregistrarse para la conferencia en:

www.tedxyouthathollywood.eventbrite.comLa participacin sera confirmada despus de recibir

el formulario de permiso y confirmacin deregistracin.